Hybrid stage I palliation for hypoplastic left heart syndrome has no advantage on ventricular energetics: a theoretical analysis.
Hybrid stage I palliation for hypoplastic left heart syndrome has no advantage on ventricular energetics: a theoretical analysis.
复制标题
左心发育不全综合征的混合 I 期姑息治疗对心室能量学没有优势：理论分析。
DOI：
10.1007/s00380-014-0604-6
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发表时间：
2016
期刊：
影响因子：
1.5
通讯作者：
Sugimachi M.
中科院分区：
文献类型：
--
作者：
Shimizu S;Kawada T;Une D;Shishido T;Kamiya A;Sano S;Sugimachi M.
一个混合程序相结合的双侧肺动脉束导管支架植入术最近被用来作为I期姑息治疗左心发育不良综合征。然而，混合手术相对于诺伍德手术在心室能量学方面的优势尚不清楚。为了澄清这一点，我们进行了计算分析与时变弹性室模型和修改后的三元件Windkessel血管模型的组合。尽管平均肺动脉（PA）压、肺流量和血氧饱和度几乎与诺伍德手术相同，但与右心室（RV）-PA分流的诺伍德手术相比，混合手术可提供更高的收缩压和更低的舒张压。结果，混合手术导致收缩压-容积面积增加，机械效率受损。因此，与采用RV-PA分流的诺伍德手术相比，混合手术在心室能量学方面可能没有优势。
A hybrid procedure combining bilateral pulmonary artery banding with ductal stenting has recently been used as stage I palliation for hypoplastic left heart syndrome. However, the advantage of the hybrid procedure over the Norwood procedure on ventricular energetics remains unclear. To clarify this, we performed a computational analysis with a combination of time-varying elastance chamber model and modified three-element Windkessel vascular model. Although mean pulmonary artery (PA) pressure, pulmonary flow, and oxygen saturation were almost equivalent with the Norwood procedure, the hybrid procedure delivered higher systolic and lower diastolic systemic arterial pressures compared to the Norwood procedure with right ventricle (RV) to PA shunt. As a result, the hybrid procedure yielded increased systolic pressure–volume area and impaired mechanical efficiency. Therefore, the hybrid procedure has probably no advantage on ventricular energetics compared to the Norwood procedure with a RV-PA shunt.